title: Heart failure patients' attitudes, beliefs, expectations and experiences of self-management strategies: a qualitative synthesis.
abstract: OBJECTIVE
  To develop a model of heart failure patients' attitudes, beliefs, expectations, and experiences based on published qualitative research that could influence the development of self-management strategies.
  
  
  METHODS
  A synthesis of 19 qualitative research studies using the method of meta-ethnography.
  
  
  RESULTS
  This synthesis offers a conceptual model of the attitudes, beliefs, and expectations of patients with heart failure. Patients experienced a sense of disruption before developing a mental model of heart failure. Patients' reactions included becoming a strategic avoider, a selective denier, a well-intentioned manager, or an advanced self-manager. Patients responded by forming self-management strategies and finally assimilated the strategies into everyday life seeking to feel safe.
  
  
  CONCLUSIONS
  This conceptual model suggests that there are a range of interplaying factors that facilitate the process of developing self-management strategies. Interventions should take into account patients' concepts of heart failure and their subsequent reactions.
authors.affiliation: 1Research, Design and Innovation, Royal Cornwall Hospital, Truro, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wingham
authors.forename: Geoff
authors.initials: G
authors.lastname: Harding
authors.forename: Nicky
authors.initials: N
authors.lastname: Britten
authors.forename: Hayes
authors.initials: H
authors.lastname: Dalal
mesh_terms: D000223:Adaptation, Psychological; D000884:Anthropology, Cultural; D002908:Chronic Disease; D019468:Disease Management; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008960:Models, Psychological; D036301:Qualitative Research; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012720:Severity of Illness Index
keywords: Heart failure; attitudes; cardiac rehabilitation; experience; meta-ethnography; qualitative synthesis